During the coronavirus pandemic, “all resuscitation in France finds a very large proportion of overweight or obese patients,” said Dr. Matthieu Schmidt of the Pitié-Salpêtrière Hospital in Paris. At the same time, “three quarters of our patients are men”, specifies this resuscitator, interviewed on France 2.
>>> Coronavirus in France: more than 12,000 dead, the number of resuscitation patients down
Finding shared by a New York surgeon colleague, Dr. Hani Sbitany of the Mount Sinai Health System. “I am in the emergency department and it is remarkable: I would say that 80% of admitted patients are men,” he said in the daily The New York Times.
In London, Professor Derek Hill of University College also notes that “more men than women” are prone to severe forms of the disease caused by the coronavirus SARS-CoV-2 and “patients who are overweight or with problems are most at risk. ”
British statistics on Covid-19 patients treated in intensive care confirm this phenomenon: 73% are men and 73.4% are overweight or obese. This count established on April 3 by the independent organization ICNARC, suggests that overweight patients are significantly less likely to get out of their passage in intensive care: 42.4% of obese patients (body mass index greater than 30 ) survive against 56.4% for those of medium or low weight (BMI less than 25).
Likewise, the male sex seems to have a poorer prognostic factor: 55.4% of women survive, compared to less than half for men (47.8%), according to these data concerning approximately 2200 patients. England, Wales and Northern Ireland, admitted to intensive care.
Better natural defenses in women
Why so many men among the serious cases? “This is an observation. To date, I have no clear explanation,” replies expert Jean-François Delfraissy, who nevertheless hypothesizes an increased frequency of multiple pathologies in men.
“I am very humble vis-à-vis this virus. I didn’t know it three and a half months ago. There are lots of question marks”, recognizes, on France Info, the one who chairs the committee scientist responsible for advising the French government on the epidemic.
An advanced lead to explain the greatest number of seriously ill men of Covid-19 in hospitals: the best natural defenses of women against viruses. This is a “known” situation in terms of viral diseases, says Professor Pierre Delobel, head of the infectious diseases department at the Toulouse University Hospital. “Innate immunity is better in women, especially before menopause”.
A nicotine effect?
For the overrepresentation of overweight people, the most immediate explanation is the markedly increased frequency of diabetes and hypertension among obese subjects. High blood pressure and diabetes mellitus are two aggravating factors for Covid-19, clearly identified in both China and Italy, as well as age and, to a lesser extent, cardiovascular and cerebrovascular diseases.
“We have a concern for the Americans. They will probably have more problems because of obesity”
This characteristic does not bode well for the epidemic in the United States, where more than one in three adults suffers from obesity and where the new coronavirus has already killed more than 15,000. “We are worried about our American friends. They will probably have more problems because of obesity,” said Professor Delfraissy.
Faced with the new disease, medicine is groping, sometimes making findings that defy the prognosis. “We have something very special with tobacco. We found that the vast majority of serious cases are not smokers, as if (…) tobacco protects against this virus, via nicotine”, notes Professor Delfraissy .
Thibaud Soumagne, resuscitator at the Besançon University Hospital (East of France), confirms to have observed “few or no smokers” in intensive care in his hospital, as already noted in the now abundant medical literature on the pandemic.
But tobacco specialists temper this trait, noting that a smoker who develops severe symptoms is more at risk because of poorer lung and cardiovascular health.